February 20, 2006

THE LATEST BAD IDEA: HEALTH SAVINGS ACCOUNTS

The folks at the Beltway Bad Idea Factory have been working overtime the last few years. The newest models off the production line are the Health Savings Accounts now being promoted by the Bush administration.

The new product is right up there with last year’s model of Social Security privatization, which unfortunately may not be dead yet. There are some valid comparisons between the two: both would be bonanzas for Wall Street firms and HSAs would be to improving quality health care what privatizing Social Security would be to protecting retires, people with disabilities, and their families.

DON’T GET SICK. HSAs are the ideal health plan for wealthy people who never get hurt or sick. They would allow people to put money in tax free savings accounts to pay for their own health care and for insurance deductibles out of their own pockets. If one is lucky, he or she may have catastrophic health insurance plans to pay for some major expenses.

DON’T SEEK TREATMENT. The inspiration behind the HSA concept is called “consumer driven health care,” an idea only a true believer in the market god could love. According to this view, health care costs are high because too many people have too much health care and don’t pay enough for it. This may come as a surprise to the 45.8 million Americans and 290,000 West Virginians who lack health insurance or the millions more who have bad and unaffordable insurance, but worship of the market god requires a Kierkegaardian leap of faith.

MORAL HAZARDS. According to market god theology, the technical term for the tendency of people with health insurance to abuse the system by using it when they get sick is called “moral hazard.” Members of the cult believe that if people had to make health decisions themselves (for which most lack the medical expertise) and pay more out of pocket for health care, everything would be just great. For a good analysis of these ideas, see Malcolm Gladwell’s "The Moral Hazard Myth" from the 8/29/05 New Yorker (available online at http://www.newyorker.com/).

The reality was pretty well summed up in a New Republic editorial published Feb. 13: HSAs “would actually make health care less affordable for people with little money and poor health—who, you might say, are the people most in need of assistance in paying their medical bills.” More on this to come.

WEST VIRGINIA HEALTH CARE NEWS

A more rational if incremental approach to health care is starting to take shape in West Virginia, although this may be more a reflection of how bad things are at the national level than how good they are here.

Governor Manchin has introduced bills which would allow some public and private clinics around the state to charge a monthly fee for primary and preventive care and which would create a $99 per month bare-bones insurance plan for adults. Thanks to Medicaid and CHIP (the Children's Health Insurance Program), the state has done an excellent job of covering children.

The state House of Delegates raised the ante by amending these proposals into one bill (HB 4021) and, more importantly, adding the creation of a panel of health care experts to come up with ways of providing coverage to the state’s uninsured residents by 2010. At this point, the state Senate has only supported the governor’s original proposal, although the House version clearly appears to be a stronger move in the right direction.

A public hearing on the subject will be held today in the House chambers at 6:00 p.m.

The Legislative Action Center on Children and Families is urging West Virginia residents to support the House vision of expanding health care. To do this, access the website www.capwiz.com/preventchildabusewv/, click on the “Support affordable health care alert," and follow simple instructions for contacting legislators. State residents can also use a toll free number, 1-877-565-3347, to reach the state house switchboard and request to speak with the legislator’s office.

GOAT ROPE CULTURAL AND LITERARY SOCIETY

An excellent book for people interested in the role of religion in American life is American Jesus: How the Son of God Became a National Icon by Stephen Prothero. The book is not about Jesus himself, but rather about different ideas of Jesus popular at different times among different groups in US history. Chapters are devoted to Jefferson's version of Jesus as an enlightened sage, the sentimental image of Jesus as "Sweet Saviour" popular in the 19th century, the manly image developed by advocates of "muscular Christianity," Jesus in the Mormon tradition, images of Jesus in the African-American community, and those developed within American Judaism, and among American Hindus and Buddhists.

GOAT ROPE ADVISORY LEVEL: ELEVATED

1 comment:

Anonymous said...

Very interesting.